Health of two different segments. one segment

Health tourismor travel for health consists of two different segments. One segment consistsof people who travel to other countries for rejuvenation purposes, and theother segment consists of people who travel for curative care that is notavailable in their countries. While the former is a luxury segment, the latteris economy. Majority of the market that travels for curative care is extremelyprice sensitive and hence it plays an important role in deciding theirdestination for medical assistance (Natarajan, 2015). With both, rising ofdisposable income and healthcare awareness, health tourism is becoming a moreand more popular across the world. The global wellness tourism industry, with agrowth rate of 9 per cent per year, is said to be growing at a 50 per centfaster rate than other tourism sectors (Natarajan, 2015).

Figure X shows therange of health products and facilities which have emerged in the past years.  Figure X: Health Continuum Source: GlobalWellness Institute Health tourismhas been widely studied and therefore has many interpretations. There is nocommonly used definition to express this term, however, the IUOTO in 1973emphasized that health tourism is “… the provision of health facilitiesutilizing the natural resources of the country, in particular mineral water andclimate” (p. 7). Mueller and Kaufmann (2001) further defined health tourism as” the sum of all the relationships and phenomena resulting from a change inlocation and residence by people in order to promote, stabilize and, asappropriate, restore physical, mental and social well-being while using healthservices and for whom the place where they are staying in neither theirprincipal nor permanent place of residence or work”. Which means that peopletravel to a destination in order to either get a medical treatment or tomaintain and improve their health. Therefore, health tourism can be generallyseen as an umbrella term for wellness tourism and medical tourism as shown in figure X. Medical paradigm is represented on thepoor health continuum, which focuses on treating and curing illness and it isreactive.

Connell (2006, p. 1094) defines medical tourism as tourism” deliberately linked to direct medical intervention, and outcomes are expectedto be substantial and long term”. Natarajan (2015) adds up that those travelling can include complexsurgeries, specialized treatments for chronic diseases, and other methods offocused care. In contrast, wellness paradigm is best understood ona continuum ranging from poor health to the state of optimal well-being, focusing on maintaining and improving health and is proactive. According to Begum(2013) wellness tourism is a field of healthcare focused on improving everydayhealth and state of wellbeing, rather than treating a disease or curingillness. Global Wellness Institute (2017, p. 11) provides more expansivedefinition of wellness tourism, namely, “ travel associated with the pursuit ofmaintaining or enhancing one’s personal wellbeing”.

It includes two types ofwellness travelers, those who travel entirely for wellness purposes (primarywellness tourists), and those who may engage in wellness activities duringtheir trip (secondary wellness tourists). In 2015 wellness sectors, whichencompasses 10 diverse sectors, shown in FigureX below represented $3. 7 trillion of economy including both internationalwellness tourism receipts and domestic wellness tourism expenditures (GlobalWellness Institute, 2017).  Figure X: Global WellnessEconomy: $3. 7 trillion in 2015 Source: Global WellnessInstitute According tothe latest data from Global Wellness Institute (2017) the wellness economycurrently represents 5% of global economic output and covers almost half of theglobal health expenditures, which was $7. 6 trillion in 2014. Wellness economyis growing enormously, especially southeast Asian countries are thefastest-growing wellness travel destinations, with a projected 22 percentannual growth rate (Gregoire, 2013).

Health Tourism in India Medical tourism can be measured indifferent ways, however in this paper we will focus only on Medical TourismIndex (MTI). MTI “ measures the attractiveness of a country as a medical tourismdestination in terms of overall country image and environment; healthcare andtourism attractiveness and infrastructure; and availability and quality ofmedical facilities and services” (“ MTI Construct – Medical TourismIndex”, 2017). It is based on opinion survey and it consists of three maindimension or groups with 34 underlying indicators among 41 countries worldwide. The first one is “ Destination Environment” and relates to overall countryenvironment (economy, safety, image and culture). The second one is “ MedicalTourism Industry” which consists of two parts, the attractiveness of county asa tourism destination and costs associated with medical tourism. And the thirdis “ Facility and Services” that includes factors related to the quality andavailability of the medical facilities and services.  According to Medical Tourism Index (MTI)2016, India is placed on the fifth place, after Canada, UK, Israel andSingapore on overall ranking, showing theFigure X below. Looking over three dimensions, in 2016 India has becomethe leading country in “ Medical Tourism Industry”, the third one in “ Quality ofFacilities & Services” and twelfth on “ Destination Environment” dimension.

Figure X: Top five destinationsaccording to Medical Tourism Index 2016 Source: Medical Tourism Index As stated inThe Economic Times article India amongfastest growing medical tourism destinations: Official (2017), India is oneof the “ fastest growing medical tourism destinations in Asia” and itis estimated that medical tourism in the country can become $9 billion industryby 2020, from about $3 billion currently, according to a white paper by CII andconsulting firm Grant Thornton India (Reddy, 2016). Ayurveda, yoga and wellnessindustry are the strongest competitive advantages of India and set countryapart from the other medical tourism destinations in the world.   In wellness tourismrankings India in not placed that high as in the medical tourism rankings. However, it’s position is still among the top twenty countries worldwide, according to Global Wellness Economy Monitor made by Global Wellness Institutein January 2017. As shown in the Figure X below, India is positioned on the 12thplace on the ranking of “ top twenty wellness tourism markets, 2015”.

India’swellness tourism expenditures in 2015 were US$11. 8 billions, they received 38. 6million wellness tourism trips, which contributed to 5. 32 million directemployments.    Figure X: TopTwenty Wellness Tourism Markets, 2015 Source: GlobalWellness InstituteWhat is evenmore surprising, according to Global Wellness Institute (2017), India is facinga robust growth in wellness tourism, which can be seen in the Figure X below. It is positioned on the 4th place after China, US and Germany, withthe 6 million wellness trips added and 8. 8% average annual growth rate from2013-2015.

This drastic constant growth could be a consequence of the “ IncredibleIndia” tourism ad campaign launched in 2002, suggests Gregoire (2013).   Figure X:  Leading Growth Markets for Wellness TourismTrips, 2013-2015 Source: GlobalWellness Institute India wellness supply is quite broad and they have a lot to offer. SusieEllis, Chairman and CEO of the Global Spa & Wellness Summit, emphasizesthat “ India’s wellness offerings are very understandable — they have yoga, meditation and ayurveda, … Right now, those are things that are reallyresonating with people… the kind of things that people want and need are thethings that India is offering.” (Gregoire, 2013).